Revenue Cycle Specialist

Revenue Cycle Specialist

Houston, Texas, United States

As the Revenue Cycle Specialist, you will be responsible for identifying, processing, and reducing missed payments, collections, and denied claims. This includes the working of claims aging reports and outstanding patient AR. This position recognizes potential issues within the claims and collections process and recommends and implements solutions for improvement. This position holder stays up with emerging technologies and payor practices and is viewed as a thought leader in revenue cycle management, who eliminates obstacles by implementing solution road maps.

Primary Responsibilities:

• Resolve healthcare claims through verbal or online inquiries to health insurance payers.
• Effectively navigate and utilize various healthcare provider software systems.
• Verify patient, insurance, billing and claim submission information for accuracy.
• Eligibility inquiries and coordination of benefits research including reaching out to the patient when necessary.
• Research missing payments and secure documents needed for posting.
• Insurance claim billing
• Work and manage claims from all aging buckets including posting and appeals.
• Resubmission of claims
• Coordination with offices to collect appropriate missing items for claim.
• Denial management-investigates, and resolves denied claims in a timely manner.
• Appropriate adjustments
• Pull EFT back-up (EOBs) as needed for claim resolution.
• Communicate with proper departments for any issues prohibiting proper allocation of payments to be posted.

Requirements:

• 2+ years of multisite remote RCM support experience
• Expert working knowledge of the RCM process and solutions, including how billing and coding impact financial revenue projections.
• Proficient with Microsoft Word and Excel
• Comfort and flexibility working in a fast-paced health environment.
• Proven track record of customer service skills

Expectations:

• Maintain or improve collection rate benchmarks (e.g., >95% of net production).
• Keep claims denial rate below industry standard thresholds (e.g., <5%).
• Reduce average days in A/R to target range (e.g., <35 days).
• Process 100% of claims within required billing timelines.
• Achieve timely resolution of outstanding or denied claims (e.g., within 30 days).
• Maintain high accuracy in payment posting and account reconciliation.

Working Conditions:

• Must be able to sit/stand for extended periods of time.
• Must be able to reach overhead as needed.
• Must be able to lift and carry up to 25 pounds as needed.
• Must be able to work in a fast-paced environment.
• Must be able to maintain attention to detail for extended periods.
• Must be able to operate standard office equipment.
• Must be able to work flexible hours, including evenings or weekends, if required.
• Must be able to perform duties with or without reasonable accommodation.

Benefits:

• BCBS Medical & Dental insurance Options
• VSP Vision Coverage
• Complimentary Life Insurance Policy (employee only)
• Short-term & Long-Term Disability
• Pet Insurance Coverage
• 401(k) plan w/match options
• HSA / FSA Account Access
• Identity Theft Protection
• Legal Services Package
• Hospital/Accident/Critical Care Coverage
• Paid Time Off

About Us:

Specialty1 Partners is a practice services organization committed to providing non-clinical, business support services to the nation's leading specialty dental practices. The company was founded in 2019 by four endodontists who wanted to provide unique and differentiated support to specialty dental practices. Originally focusing on support to endodontics practices (under the Endo1 brand), Specialty1 Partners quickly expanded its support to periodontics and oral surgery practices.

Since its founding, Specialty1 Partners has grown rapidly to become one of the largest private owners of specialty dental practices in the US. Headquartered in Houston, TX, Specialty1 Partners is led by its founders and a management team that is focused on ongoing growth and delivery of best-in-class services across its network of practices. Specialty1 Partners currently has over 225 locations across 28 states.

Salary: $55,00 - $70,000 / per annum

Modality: Remote